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Papillary and Follicular Thyroid Cancer
Ashley C. Mays, MD; Paige Bennett, MD
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Papillary thyroid cancer
            • Papillae with neoplastic cells surrounding fibrovascular stalk
              • Typically unencapsulated
          • Follicular thyroid cancer
            • Typically unifocal follicular cells with extension outside capsule and vascular invasion
              • Hurthle cell variant: Considered to have poorer prognosis than follicular; poor radioactive iodine avidity
              • Insular variant: Poorly differentiated follicular; commonly invasive with regional/distant metastases

        IMAGING

        • F-18 FDG PET/CT Findings

          DIFFERENTIAL DIAGNOSIS

            PATHOLOGY

            • General Features

              • Staging, Grading, & Classification

                CLINICAL ISSUES

                • Presentation

                  • Demographics

                    • Natural History & Prognosis

                      • Treatment

                        DIAGNOSTIC CHECKLIST

                        • Consider

                          • Image Interpretation Pearls

                            Selected References

                            1. Basu S et al: Designing and developing PET-based precision model in thyroid carcinoma: The potential avenues for a personalized clinical care. PET Clin. 12(1):27-37, 2017
                            2. Kwon SY et al: Prognostic value of preoperative 18F-FDG PET/CT in papillary thyroid cancer patients with a high metastatic lymph node ratio: a multicenter retrospective cohort study. Nucl Med Commun. 38(5):402-406, 2017
                            3. Haugen BR et al: 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 26(1):1-133, 2016
                            4. Hempel JM et al: Impact of combined FDG-PET/CT and MRI on the detection of local recurrence and nodal metastases in thyroid cancer. Cancer Imaging. 16(1):37, 2016
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Imaging

                              • Pathology

                                • Clinical Issues

                                  TERMINOLOGY

                                  • Definitions

                                    • Papillary thyroid cancer
                                      • Papillae with neoplastic cells surrounding fibrovascular stalk
                                        • Typically unencapsulated
                                    • Follicular thyroid cancer
                                      • Typically unifocal follicular cells with extension outside capsule and vascular invasion
                                        • Hurthle cell variant: Considered to have poorer prognosis than follicular; poor radioactive iodine avidity
                                        • Insular variant: Poorly differentiated follicular; commonly invasive with regional/distant metastases

                                  IMAGING

                                  • F-18 FDG PET/CT Findings

                                    DIFFERENTIAL DIAGNOSIS

                                      PATHOLOGY

                                      • General Features

                                        • Staging, Grading, & Classification

                                          CLINICAL ISSUES

                                          • Presentation

                                            • Demographics

                                              • Natural History & Prognosis

                                                • Treatment

                                                  DIAGNOSTIC CHECKLIST

                                                  • Consider

                                                    • Image Interpretation Pearls

                                                      Selected References

                                                      1. Basu S et al: Designing and developing PET-based precision model in thyroid carcinoma: The potential avenues for a personalized clinical care. PET Clin. 12(1):27-37, 2017
                                                      2. Kwon SY et al: Prognostic value of preoperative 18F-FDG PET/CT in papillary thyroid cancer patients with a high metastatic lymph node ratio: a multicenter retrospective cohort study. Nucl Med Commun. 38(5):402-406, 2017
                                                      3. Haugen BR et al: 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 26(1):1-133, 2016
                                                      4. Hempel JM et al: Impact of combined FDG-PET/CT and MRI on the detection of local recurrence and nodal metastases in thyroid cancer. Cancer Imaging. 16(1):37, 2016